title: Outcome of severe obsessive-compulsive disorder with schizotypal features: a pilot study.
abstract: OBJECTIVE
  Long-term outcome of patients with severe obsessive-compulsive disorder (OCD) and schizotypal features has been rarely studied. We investigated this issue in this retrospective pilot study.
  
  
  METHODS
  Twenty-two patients with severe OCD and schizotypal features were identified by chart review. Another 22 OCD patients without schizotypal features (OCD-NS) served as the comparison group. Those with schizotypal features must not fulfill a diagnosis of schizophrenia or schizotypal disorder. After an average follow-up of 6.6 years, each patient received a re-diagnosis clinical interview. Relevant demographic and clinical data were collected. Patients with schizotypal features were classified into two groups after re-diagnosis: those with schizophrenia or schizotypal disorder (OCD-SS group, n = 9) and those with only schizotypal traits (OCD-ST group, n = 13) that did not fulfill a well-formed schizophrenia-spectrum disorder. Demographic data, family history, clinical symptoms, and OCD course were compared among the three patient groups.
  
  
  RESULTS
  Compared with the OCD-NS group, the OCD-SS group was significantly less educated, less likely to be married or female, and had earlier onset of illness and poorer OCD course (p<0.05). There was no significant difference in any demographic and clinical variables between the OCD-SS and OCD-ST groups except that the OCD-ST group had a significantly better OCD course (p < 0.01).
  
  
  CONCLUSIONS
  The findings suggest that a substantial proportion of the patients with severe OCD and schizotypal features evolve into schizophrenia spectrum disorder and are associated with a poor long-term outcome, whereas the OCD-NS group might stay with limited manifestations of schizotypal features and have a better outcome.
authors.affiliation: Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Lung-Cheng
authors.initials: LC
authors.lastname: Huang
authors.forename: Tzung-Jeng
authors.initials: TJ
authors.lastname: Hwang
authors.forename: Guan-Hua
authors.initials: GH
authors.lastname: Huang
authors.forename: Hai-Gwo
authors.initials: HG
authors.lastname: Hwu
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D010555:Personality Inventory; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D011618:Psychotic Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000150:complications; D012569:Schizotypal Personality Disorder / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D012720:Severity of Illness Index; D017678:Sex Distribution; D012959:Socioeconomic Factors; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents